How Fluoride Works

Dental
caries,
commonly known as cavities, are created when certain oral bacteria
utilize
sugars and carbohydrates from the food we eat and secrete an acid. This
acid
removes minerals from the teeth, causing dental caries. Fluoride adds
minerals
back to the tooth enamel, strengthening it and making it resistant to
caries. (http://oralhealth.suite101.com/article.cfm/water_fluoridation)

A
variety of different types of fluoride compounds are used, with
differing
sources. Historically, the fluoride used is a byproduct of aluminum
manufacturing and the creation of certain fertilizers. Prior to
commercialization as a way to enrich the water, many of these compounds
were
considered hazardous waste. Fluoride sources for municipal water are
abundant
and inexpensive. Fluoride is added by water utility companies, at
varying
degrees of concentration depending on the natural fluoride content of
the
water. The optimum level is considered 1ppm.

Supporters
of Fluoridation

The
original push for water
fluoridation was heavily touted by dentists as a safe and effective
measure to
reduce cavities. The American Dental Association has officially
endorsed
municipal fluoridation for over 40 years. (http://www.ada.org/2467.aspx)
They
support universal fluoridation and point to a body of peer reviewed
scientific
evidence to support their claims. In 2005 the ADA released a 72 page
report
entitled ‘Fluoridation Facts’ which was made available on their
website. The stated goal of this
report is “setting the facts straight” on fluoride. This document
dismisses
the counter claims as “junk science” and warns against “erroneous
health claims
made against water fluoridation” (pg. 41) that are found on the
internet.
Recently, counterclaims have become prevalent that this report itself
is based
on outdated science. In the last few months, as part of a broader a
website
redesign, the ADA has removed their prominent link to this pdf. I host
this PDF
here. It is worthy of note
however, that the ADA has also recently recommended
limiting fluoride intake for infants and babies.

The
Center for Disease Control also supports community water fluoridation,
as do
less widely known groups including the American Academy of Family
Pediatricians
and the American Council on Science and Health. They cite the same
primary reasons
for support as the ADA.

Opponents of Fluoridation

The
anti-fluoridation movement
tends to get a bad rap. This is in part due to its origins. When
fluoridation first
began in the cold war era, many anti-fluoridation activists opposed the
practice due to suspicions that it was part of a communist plot to
poison US
drinking water. When the Soviet Union began fluoridating their own
water, this
group lost a great deal of steam and credibility. They have since
rebounded with
concerns raised by scientific evidence.

The
best umbrella term to describe opponents of community water
fluoridation these
days is “concerned citizens.” While often stereotyped as conspiracy
theorists
and alarmists, this group actually consists of a number of medical
professionals, scientists and even dentists in addition to a vocal
citizen’s
movement. In terms of scientific clout, one of the biggest members of
the
anti-fluoridation movement is the Environmental Protection Agency
Headquarters
Union of Scientists – a union that represents approximately 1,500
scientists,
engineers, lawyers, and other EPA staff in Washington, D.C.

The
EPA Headquarters Union initially opposed the EPA administration’s
decision to
label dental fluorosis a cosmetic
problem rather than a health concern. The Union believed that the
maximum
allowable concentrations of fluoride in municipal water should be
lowered to
prevent dental fluorosis. Since that time the union has made the fight
broader,
pointing to a growing body of scientific literature that raises
concerns about
the effects of fluoride. The Unions' official statement mentions hazards
including “acute toxic hazard, such as to people with impaired kidney
function,
as well as chronic toxic hazards of gene mutation, cancer, reproductive
effects, neurotoxicity, bone pathology and dental fluorosis.” (http://www.nteu280.org/Issues/Fluoride/NTEU280-Fluoride.htm)
The Union advocates lowering the maximum allowable level of fluoride in
municipal water from 4 mg/L as well as lowering the recommended level
from
1ppm.

The
other most visible group of anti-fluoridationists are found on the
internet.
When covering a fluoridation dispute in Bellingham, Washington, Time
magazine
reported that at least one couple joined the anti-fluoridation
activists after
they Googled the term fluoridation and found that “Nine of the first 10
items
that came up were decidedly antifluoride.” (http://www.time.com/time/magazine/article/0,9171,1118379,00.html)
While there are a variety of websites dedicated to the
anti-fluoridation
movement, most link back to the Fluoride Action Network (FAN) at http://www.fluoridealert.org/,
an
umbrella organization which compiles fluoridation related news, and
‘fact
sheets.’ In private correspondence with the FAN, one employee listed
the
creation of the FAN in 2000 as one of the most important momentum
changers in
the last decade of fluoridation controversy. They also emphasized FAN’s
decision to focus on the science of the controversy, rather than more
farfetched claims (such as communist conspiracies).

One
last group worthy of note is The National Academy of Sciences. While it
was
this groups initial report on fluoridation in Grand Rapids that paved
the way
for the widespread implementation of community water fluoridation –
they have
since raised concerns about how much fluoride is too much. Their 2006
report
claims that the EPA standard of 4 mg/L is too high and leads to adverse
health
effects. (http://dels.nas.edu/dels/rpt_briefs/fluoride_brief_final.pdf)

Fluorides'
abitlity to protect teeth by strengthing enamel is undisputed. These
days, many toothpastes contain fluoride. This topical use is not
considered controversial. However, questions remain about the safety of
drinking fluoride.